Why do rehabilitation clinicians exist? What do clinicians do? What impact do they have? Obviously, rehabilitation has multiple facets. A patient experiences it. A clinician provides it. A business grows from the exchange between patient and clinician. A payer pays for the service. Why should clinical outcomes enter into the equation? I'd like to thank Therapy Partners for asking for my perspective. I'd also like to thank Ben Fung for the opportunity to discuss this important issue.
The days of saying you provide quality care are gone. The fee for service model is outdated. The train has left the station going down the track of value based purchasing. Businesses should never assume quality care is being provided. Payers are demanding data in determining payment models.
Health care has historically overlooked quality control. Many years ago, my husband was employed in this area at a metal stamping plant. The business model was easy: get as many contracts as possible to create "widgets" for the Big Three. (Big Three meaning General Motors, Ford and Chrysler.) Contracts had specifications as to the amount of production error allowed. If a widget were outside of the error parameters it was not to be shipped... IF the widget were shipped and found to be out of specifications, the metal stamping plant assumed a negative financial event.
We are now entering a historical milestone: we have to define the quality of care we will provide. We need systems in place to manage the customer experience, the clinician's care, the payer's needs and the financial health of the business.
Outcomes data is a high priority in service models in rehabilitation. Outcomes data is used in a variety of areas. Outcomes data: 1) can be shared via direct access to help drive business to you, 2) is a priority in managing clinical performance, 3) reduces costs associated with unnecessary continuing education courses, 4) provides objectivity when evaluating clinical performance, 5) contract negotiations focused on quality versus volume.
Without outcomes data, you are left with the "how low can you go?" game focused on number of visits. Less visits does not equate to better care. Capped visits in managed care didn't work... capped visits in worker compensation in California didn't work (higher costs shifted to drugs)... your patients deserve more than visits determining quality.
Outcomes matter when it comes to value based purchasing. Financial returns will be tied to outcomes data. Even if you firmly believe you are focused on only providing care to a patient who is also the sole payer. Patients are becoming savvy in how they choose providers. How many patients are you loosing by not having outcomes data at your fingertips? (How much will I improve? How long will it take? How much will it cost?)
Until next time,